Healthcare Provider Details

I. General information

NPI: 1891179404
Provider Name (Legal Business Name): VIBHA CHIKKATUR MURTHY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2015
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 HOAGIE DR
BEL AIR MD
21014-1884
US

IV. Provider business mailing address

604 HOAGIE DR
BEL AIR MD
21014-1884
US

V. Phone/Fax

Practice location:
  • Phone: 410-893-4844
  • Fax:
Mailing address:
  • Phone: 410-893-4844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number55519
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101273988
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: